In yet another Unum bad faith insurance claim lawsuit, a former Rhode Island business owner who suffers from a debilitating condition is suing the company for denying his disability benefits according to the provisions of his Unum long-term disability policy.

In this particular Unum lawsuit, plaintiff, John G., who was the owner and operator of a business that rented tents, tables, and construction equipment since 1986 had purchased a private disability insurance policy with Unum.

In 2003, John alleges he became totally disabled under the term of his policydue to to conditions affecting his back, hips, knees, and right hand, which Unum determined met eligibility requirements and began paying his disability benefits.

However, in March 2014, Unum abruptly terminated his disability benefits, alleging that he was no longer entitled to benefits under the policy because he failed to meet the policy’s definition of disability.

John appealed Unum’s decision to terminate his disability benefits, providing the insurance company with sufficient evidence establishing his continued entitlement to his full policy benefit.

Unum issued a decision on John’s appeal, determining that he was totally disabled from March 6, 2015 to June 7, 2015 and was indeed entitled to disability benefits during this period.

However, despite the evidence John presented to Unum, the company stated that John did not meet the policy’s definition of disability from March 23, 2014 to March 5, 2015, or any time after June 7, 2015 and has refused to pay disability benefits for these periods.

John is suing Unum claiming that since the onset of his disability in 2003 to the present, he has continuously met the policy’s definition of disability and is entitled to payment of all disability benefits owed to him, plus interest on all improperly withheld payments.

He has filed this Unum lawsuit on four counts including breach of contract, bad faith, breach of implied covenant of good faith, declaratory relief.  John has requested a jury trial for this case.

Unum’s Disability Benefits Denial Tactics

Unum has had a long history of allegedly delaying, and ultimately denying valid disability benefits claims. Some of the most common methods used by Unum to avoid payment include the following:

• Misclassification: Unum has repeatedly misclassified claimants for disability benefits in an effort to disqualify them from eligibility for payments under their insurance policy. Unclear and misleading language used in Unum’s disability insurance policies can often lead to extended delays or failure to pay on these policies altogether.
• Altering the Contract: Unum has been accused of making changes to insurance policies without the prior authorization and consent of the policyholder while the coverage was still in force. These changes may have been made prior to the date of the insurance claim or after the fact in an effort to avoid payment. In some cases, Unum never informed the policyholder of these changes at all.
• Misuse of Medical Experts: Some Unum policyholders allege that the company obtained opinions from medical examiners who were not properly qualified or knowledgeable in the particular injury or medical problem in question. In other cases, Unum may have contracted with third-party examiners to act on behalf of the company in denying claims without proper medical examination or in lieu of a true third-party examination by an unbiased medical professional.
• Delay Tactics: Unum is also accused of repeatedly requesting additional information and requiring claimants to fill out redundant and unnecessary forms in an effort to delay the processing of valid claims. By requiring policyholders to provide the same information over and over or requiring visits to a specific clinic, the insurer can increase the likelihood of errors on the part of the claimant that can lead to a denial of the insurance claim.

If you or someone you love has been denied disability benefits claims by Unum or other disability insurance provider, you have legal protection under the law. An experienced attorney can evaluate your case free of charge, inform you of your legal rights and options, and help you recover your unpaid insurance claim and more.

The Unum Denied Disability Benefits Lawsuit is Case No. 1:16-cv-00123-ML-LDA in the U.S. District Court for the District of Rhode Island.